Is laparoscopic surgery as effective and feasible as open resection for gastric gastrointestinal stromal tumors (GIST) lager than 5cm? Meta-analysis

Jianxin Cui, Aizhen Cai, Hongqing Xi, Kecheng Zhang, Rong Chen, Bo Wei, Lin Chen. Department of General Surgery, Chinese People’s Liberation Army of General Hospital

Background: To determine by meta-analysis, whether laparoscopic surgery is as effective and feasible as open resection for patients with gastric gastrointestinal stromal tumors (GIST) lager than 5cm?

Methods: All records that compared laparoscopic with open surgery for GIST lager than 5cm published in English from January 1995 to August 2015 were identified in PubMed, Embase, Web of Science, Google scholar and Cochrane library database. The quality of the literatures were assessed by NOS scale. Tumor size, operation time, blood loss, postoperative hospital stay, complication rate and disease free survival rate were collected. Meta-analyses were performed using weighted mean differences for continuous variables, odds ratios for dichotomous variables, and hazard ratios for time-to-event variables.

Results: No eligible randomized controlled trials were identified, but four non-randomized trials were analyzed, comprising 150 GIST patients with similar tumor size. In the pooled data of 77 patients who underwent laparoscopic resection and 73 open resection, laparoscopic surgery was associated with shorter postoperative hospital stay (P<0.05). However, there were no significant differences of operation time, blood loss, complication rate and disease free survival rate between the two groups.

Conclusions: Our findings showed that for patients with comparable tumor size, surgical technique did not significantly influence the operation factors and oncologic outcomes, suggesting laparoscopic resection is as acceptable as an open procedure in treatment for gastric large GIST.

Key words: Laparoscopic; Open resection; Gastrointestinal stromal tumors (GIST); Meta-analysis 

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